Att D - Sample PSR

ATTACHMENT – D: Sample PSR

Prevention Status Report
Tobacco Control

SAMPLE STATE

Why is tobacco control important?
Tobacco is the leading cause of preventable death in the US and in STATE. In the US, 40% of adult nonsmokers
and 54% of children (aged 3–11 years) are exposed to secondhand smoke. Tobacco use results in $96 billion in
medical expenditures and $97 billion in lost productivity annually in the US. In STATE, $X billion in personal
health care expenditures and $X billion in lost productivity are related to smoking. States that invest in proven
strategies protect kids from tobacco, decrease smoking rates, reduce tobacco-related healthcare costs, and
prevent deaths.

Public health indicators
Proportion of adults who smoke cigarettes, 2009

Healthy People 2020 Target = 12.0% (Red line)

XX

Proportion of high school students who smoke
cigarettes, 2009

Healthy People 2020 Target = 16.0% (Red line)

16.0%
XX

US*

21.0%

17.9%
US*
0%

10%

20%

30%

40%

19.5%

50%

* Median state prevalence

0%

10%

20%

30%

40%

50%

*National prevalence among high school students

Policy indicators
State cigarette excise tax, 2010
STATE’S tax is $2.22 compared to the highest state tax of $4.35. Healthy People 2020 Target is a state
increase of $1.50 per pack.
State smoke-free policy, 2010
STATE requires smoke-free workplaces, including restaurants, bars, and other public places. Healthy
People 2020 Target = All 50 states and the District of Columbia to have statewide smoke-free laws.
State funding for tobacco control, FY2010
STATE allocated 25% of the CDC recommended funding for tobacco control ($10 million of $40 million).

What can be done to prevent illness and death and reduce health care costs?
States can make a significant difference in public health by employing high-impact, cost-effective tobacco control
and prevention strategies. MPOWER: Monitor tobacco use and prevention policies, Protect people from tobacco
smoke, Offer help to quit tobacco use, Warn people about the dangers of tobacco, Enforce bans on tobacco
advertising, promotion, and sponsorship, and Raise state cigarette taxes on tobacco.

CDC Atlanta – Office for State, Tribal, Local and Territorial Support
For more information, please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
Email: [email protected]
Web: www.cdc.gov/ostlts

KEY:
= Healthy Achievement
= Healthy Progress
= Recommendations for Progress

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Prevention Status Report
Nutrition, Physical Activity, and Obesity

SAMPLE STATE

Why are nutrition, physical activity, and obesity important?
A healthful diet and regular physical activity benefit the health of children and adults. Poor diet and physical
inactivity contribute to many serious and costly health conditions including obesity, heart disease, diabetes, some
cancers, unhealthy cholesterol and high blood pressure. Obesity is associated with increased blood pressure and
unhealthy cholesterol; chronic diseases such as heart disease, diabetes, some cancers, and osteoarthritis;
complications of pregnancy; and death at earlier ages. In 2007-2008, 17% of children and adolescents and 34% of
adults were obese. Among adults, the medical costs associated with obesity are $147 billion.

Public health indicators
Proportion of adults who are obese, 2009

XX

Proportion of high school students who drank a
can, bottle, or glass of soda or pop at least one
time per day, 2009

29.1%

US

XX

26.7%
0%

10%

20%

30%

40%

50%

26.8%

US

29.2%
0%

10%

20%

30%

40%

50%

Proportion of high school students who are
obese, 2009

XX

Proportion of high school students who attended
physical education classes on 1 or more days in
an average week when they were in school, 2009

10.2%

US

12.0%
XX
0%

10%

20%

30%

40%

44.9%

50%

US
Proportion of low income children 2- < 5 years
of age who are obese, 2009

XX

14.5%

US

14.7%
0%

10%

20%

30%

40%

50%

CDC Atlanta – Office for State, Tribal, Local and Territorial Support
For more information, please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
Email: [email protected]
Web: www.cdc.gov/ostlts

56.4%
0%

20%

40%

60%

80%

100%

ATTACHMENT – D: Sample PSR

Prevention Status Report
Nutrition, Physical Activity, and Obesity

SAMPLE STATE

Policy indicators
Sale of less nutritious foods and beverages in secondary schools, 2008
In 2008, 38% of secondary schools in STATE did not allow students to purchase baked goods that are not low in
fat, salty snacks that are not low in fat, candy, or soda pop or fruit drinks that are not 100% juice in vending
machines or at the school store, canteen, or snack bar.

Physical education time requirement for high school students, 2010
STATE does not have a physical education time requirement for high school students.

State procurement policy for foods and beverages, 2010
STATE does not have a state procurement policy for foods and beverages.

Inclusion of nutrition and physical activity standards in state regulations of licensed child care
facilities, 2008
STATE’S child care regulations include some model policies for healthy eating and physical activity.
Average birth facility score for breastfeeding support, 2009
STATE has an average birth facility score of 74. The US national score is 65.

What can be done to improve nutrition and physical activity and help prevent obesity and
other chronic diseases?
1)

Support school districts in implementing strong nutrition standards that restrict the availability of low-nutrient,
energy dense foods and sugar sweetened beverages.

2)

Pass a state policy to increase physical education (PE) time requirements and do not grant PE exemptions
for participation in sports, club memberships, or academic reasons.

3)

Establish state procurement policy standards for foods and beverages purchased, contracted, distributed or
sold in government facilities.

4)

Implement improvements in nutrition and physical activity standards in state regulations of licensed child care
facilities using standards in “Preventing Childhood Obesity in Early Care and Education Programs” as a
guide.

5)

Work with hospitals and birth centers in STATE to implement evidence-based practices that support
breastfeeding.

CDC Atlanta – Office for State, Tribal, Local and Territorial Support
For more information, please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
Email: [email protected]
Web: www.cdc.gov/ostlts

KEY:
= Healthy Achievement
= Healthy Progress
= Recommendations for Progress

ATTACHMENT – D: Sample PSR

Prevention Status Report
Food Safety

SAMPLE STATE

Why is food safety important?
Diseases spread by contaminated foods continue to challenge the public health system. Each year, an
estimated 1 in 6 Americans develop an acute foodborne infection, almost 128,000 are hospitalized and 3000 die,
with the worst consequences in the very young and the elderly.² The health costs of four bacterial infections
alone were estimated to be $6.5 billion/year, not including the costs of lost consumer confidence, product
advisories and recalls. Large foodborne outbreaks continue to occur with a wide spectrum of implicated foods,
including fresh produce and processed foods, as well as foods of animal origin. In recent years, prolonged
nationwide outbreaks of Salmonella infections strained public health departments and highlighted the need for
fast and coordinated action.

Public health response indicators
Proportion of E. coli O157 PFGE patterns reported to CDC (i.e., uploaded into PulseNet) within 4
working days of receipt of the isolate in the state Public Health Lab, 10/1/09 – 9/30/10
National Target (CDC Public Health Emergency Preparedness Cooperative Agreement) = 90%
XX = 95% (Note: 9 states = 100%; 6 states = 0.0%)
US = 63.4%

Annual proportion of Salmonella cases reported to CDC (National Notifiable Diseases Surveillance
System) with PFGE patterns uploaded into PulseNet, 2009
XX = 85% (Note: 33 states = 100%)
US = 79.1%

What can be done to prevent illness and death and reduce health care costs?
1)

2)

3)

Improve foodborne disease surveillance and detection activities
a.

Determine the specific strain and perform DNA fingerprinting for all Salmonella and Shiga toxin
producing E. coli (STEC).

b.

Interview all Salmonella, STEC, and Listeria cases with a standardized form.

Increase the speed and completeness of outbreak investigations
a.

Employ trained interview team approach to interviews.

b.

Conduct targeted environmental health investigations.

c.

Conduct rapid traceback of implicated foods where indicated.

Increase local and state foodborne disease prevention activities
a.

Require a certified kitchen manager to be present in each food service establishment.

b.

Restaurants should publicly post the results of the most recent food safety inspection.

c.

State and local jurisdictions should adopt and implement as many provisions as possible from the
2009 FDA Model Food Code.

d.

Conduct inspections of all state-regulated food processors at regular intervals.

CDC Atlanta – Office for State, Tribal, Local and Territorial Support
For more information, please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
Email: [email protected]
Web: www.cdc.gov/ostlts

KEY:
= Healthy Achievement
= Healthy Progress
= Recommendations for Progress

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Prevention Status Report
Teen Pregnancy Prevention

SAMPLE STATE

Why is teen pregnancy prevention important?
Each year in the United States, about 750,000 women under age 20 become pregnant. Most teen pregnancies –
nearly two-thirds of those to mothers younger than age 18 and more than half among mothers aged 18–19 years
– are unintended. The costs of teen childbearing are at least $9.1 billion annually in the US. The cost to STATE
taxpayers was estimated to be at least $XX million in 2004.³ Overarching goals for this priority include policy and
systems changes to: implement effective prevention programs that fit the unique needs of the youth and
community; delay initiation of sexual activity among teens; and increase the use of contraception, particularly
long-acting, reversible methods, among sexually active teens.

Public health indicators
Teen birth rate, 2008

Birth control pill or Depo-Provera use before
last sexual intercourse among currently
sexually active high school students, 2009

(Per 1,000 women aged 15–19 years)

XX

39.8

US

XX

41.5
0

15

30

45

31.3%

US
60

22.9%

75
0%

10%

20%

30%

40%

50%

Proportion of high school students who have
ever had sex, 2009

Condom use during last sexual intercourse among
currently sexually active high school students, 2009

XX

XX

48.1%

US

US

46.0%
0%

20%

40%

60%

66.4%

80%

100%

61.1%
0%

20%

40%

60%

80%

100%

Policy indicator
Medicaid family planning expansion through state approval, 2010
Medicaid expansion for family planning services in STATE covers all women, including teens.

What can be done to prevent teen pregnancy and reduce health care costs?
In addition to helping the significant proportion of teens who are not sexually active to remain so through
evidence-based prevention, education, and support, a key to reducing teen pregnancy is to make sure that
sexually active adolescents at risk for pregnancy are connected to family planning services. One way to improve
access for teens is to continue to provide Medicaid family planning services to women less than 19 years of age,
either through the Medicaid waiver or by converting to the State Plan Amendment recently made available by the
Centers for Medicare & Medicaid Services (CMS).
CDC Atlanta – Office for State, Tribal, Local and Territorial Support
For more information, please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
Email: [email protected]
Web: www.cdc.gov/ostlts

KEY:
= Healthy Achievement
= Healthy Progress
= Recommendations for Progress

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Prevention Status Report
HIV Prevention

SAMPLE STATE

Why is HIV prevention important?
In 2010, the White House released the first National HIV/AIDS Strategy for the United States to promote a national
urgency and coordinated response to the ongoing HIV epidemic. Today, more than 1.1 million people in the US
are living with HIV infection and 1 in 5 of them is unaware of their infection. Increasing knowledge of serostatus
among HIV-infected persons leads to reduction in risk behaviors and reductions in new HIV transmissions and
connects people with needed care and treatment. The lifetime cost of medical treatment for HIV-infected persons
is more than $350,000, making HIV prevention an extremely cost-effective public health intervention.

Public health indicators
AIDS diagnosis rate, 2008

Late HIV diagnosis, 2007

(New cases per 100,000 population aged 13 years and
older)
Healthy People 2020 Target = 13.0 new cases per
100,000 population (Red line)

Data are not available from sources used for this report.
State collected data may be available.

XX
US

32.0%
0%

XX

11.7

US
10

20%

30%

40%

50%

Deaths among persons with AIDS, 2007
(Rate per 100,000 population aged 13 years and older)

14.8
0

10%

20

30

40

XX

6.9

US

7.1
0

5

10

15

20

Policy indicators
Reimbursement for screening
Medicaid does not reimburse for HIV screening in all settings and all population in STATE.

HIV testing laws
State HIV testing laws are consistent with CDC's 2006 HIV testing recommendations.

CD4 and VL lab reporting
State law or regulation requires reporting of all CD4 and viral load results for surveillance purposes.

What can be done to prevent illness and death and reduce health care costs?
STATE can work to further expand HIV prevention activities and target resources to interventions, geographic areas,
and populations that can have the greatest impact toward achieving the goals of the National HIV/AIDS Strategy.
Improved policies that would support the National Strategy include the following:
1) Expand medicaid reimbursement for HIV screening to all populations and settings.

CDC Atlanta – Office for State, Tribal, Local and Territorial Support
For more information, please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
Email: [email protected]
Web: www.cdc.gov/ostlts

KEY:
= Healthy Achievement
= Healthy Progress
= Recommendations for Progress

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Prevention Status Report
Healthcare-associated Infection Prevention

SAMPLE STATE

Why is healthcare-associated infection prevention important?
One in every 20 hospitalized patients will contract a healthcare-associated infection (HAI), causing excessive,
preventable illness and higher healthcare costs. It is estimated that HAIs incur an estimated $28 to $33 billion in
excess healthcare costs each year in hospitals in the US. States work with CDC to monitor and prevent HAIs in all
types of healthcare facilities. Reporting HAI data allows prevention efforts to be targeted and measured. States also
work on broad prevention collaboratives targeting specific infection and bacteria types, such as methicillin-resistant
Staphylococcus aureus (MRSA). As our knowledge of prevention strategies grows, HAIs are increasingly preventable.

Public health indicators
Central line-associated bloodstream infection (CLABSI) – Standardized Infection Ratio (SIR), 2010
Healthy People 2020 Target = 0.25 Standardized Infection Ratio (SIR) or 75% reduction

XX

1.24

US

0.82
0.00

0.50

1.00

1.50

2.00

Policy indicators
XX% Acute care facilities reporting to CDC
Percent of hospitals reporting any HAI data to CDC's National Healthcare Safety Network (NHSN).
Validating HAI data sent to CDC
STATE had no efforts in place in 2009 to validate data sent to CDC's National Healthcare Safety Network
(NHSN).
Participation in statewide prevention efforts
STATE is leading or taking part in broad prevention collaboratives.

 CLABSI

SSI

 CAUTI

VAP

 C. difficile

Dialysis

Ambulatory care

Long-term care

MRSA

What can be done to prevent illness and death and reduce health care costs?
1)

Continue to expand HAI prevention efforts inside and outside of hospitals, including setting up broad
collaborative partnerships for preventing infections in settings such as long-term care, dialysis centers and
outpatient surgery centers.

2)

Focus efforts on ensuring CDC guidelines are followed by every healthcare provider and facility.

3)

Advocate and support data validation efforts and ensure Recovery Act investments are being used effectively
for maximum impact.

CDC Atlanta – Office for State, Tribal, Local and Territorial Support
For more information, please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
Email: [email protected]
Web: www.cdc.gov/ostlts

KEY:
= Healthy Achievement
= Healthy Progress
= Recommendations for Progress

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Prevention Status Report
Motor Vehicle Injury Prevention

SAMPLE STATE

Why is motor vehicle injury prevention important?
Motor vehicle crashes represent one of the largest and most preventable public health problems facing our nation today.
Motor vehicle crashes are the leading cause of death among US residents aged 5-34 years. In 2009, nearly 34,000
people were killed and another 2.6 million treated in emergency departments. The economic impact of these injuries
totals more than $230 billion per year. These costs are borne by many, including individuals, employers, the health care
system, and public and private insurance.

Public health indicators
Motor vehicle-related death rate, 2009 (rate per 100,000 population)
Healthy People 2020 Target = 12.4 per 100,000 population (Red line)

XX

18.8

US

11.0
0

5

10

15

20

25

Motor vehicle-related
death rate
among
adolescents,
2009 (rate
100,000
population
vehicle traffic-related
death
rate among
adolescents,
2009per
(rate
per 100,000
population
15–19 years)
aged
15–19aged
years)
XX

24.7

US

14.9
0

10

20

30

40

50

Seat belt use, 2009
Healthy People 2020 Target = 92.4% (Red line)

XX

77.8%

US

84.0%
0%

20%

40%

60%

80%

100%

CDC Atlanta – Office for State, Tribal, Local and Territorial Support
For more information, please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
Email: [email protected]
Web: www.cdc.gov/ostlts

ATTACHMENT – D: Sample PSR

Prevention Status Report
Motor Vehicle Injury Prevention

SAMPLE STATE

Policy indicators
Seat belt law
STATE has a primary enforcement law for all seating positions.

Child safety restraint law
STATE requires that all children age 5 years and younger or less than 60 pounds must be in a child
restraint.

Graduated drivers license (GDL) law
STATE has achieved a "good" rating; however, improvements could be made to strengthen the GDL
system.

Alcohol ignition interlock law
STATE does not require any ignition interlock system for offenders.

What can be done to prevent injury and death and reduce health care costs?
1) Require that children ride in age- and size-appropriate seats until at least age 8 and 4 feet 9 inches tall.
2)

Start nighttime restriction at 10:00 pm during GDL probationary period.

3)

Limit passengers to no more than one during GDL probationary period.

4)

Require installation of ignition interlocks for all convicted first-time and repeat offenders.

CDC Atlanta – Office for State, Tribal, Local and Territorial Support
For more information, please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
Email: [email protected]
Web: www.cdc.gov/ostlts

KEY:
= Healthy Achievement
= Healthy Progress
= Recommendations for Progress